Red flushes and my liver tests, time to stop?

I was quite a heavy drinker in periods over the last 15-20 years up until the end of January this year.

Sometimes it was 2-4 times per week, some weeks nothing, sometimes periods of 6-8 weeks or longer without. Generally it was not daily though there were periods of several days in a row.

Essentially well above average, and I want to be clear on that

Some weeks up to 50 pints of beer

I have decided now at maximum to have alcohol no more than once per month if at all.

I think its time to stop which is ok, just concerned I went too far

I ate well, kept myself in good shape, exercised a lot. I am just worried that I did not stop soon enough.

The only symptom I can really pin down is in the last 2 years sometimes when I have a small amount of alcohol my face goes very red or has red patches which vanish after around 30 mins. I am aware of Asian Flush, ( I am not asian) but worry that this could be a sign of liver weakness

I post my blood work below over roughly a 2 year period. These were done in Ireland

My question - although the standard LFTS are still within the normal ranges, is the increase over the two year period a concern? Also would be interested in your opinion on any other measures

I went for a Ultrasound last week as I was feeling a dull pain not very often on my right front side, Liver, Gall Bladder came back fine, - though I am aware that Ultrasound are not 100% accurate, based on your thoughts on the above blood work, could it be possible I have Alcoholic hepatitis or cirrhosis?

Any advice, comments or feedback would be great

Where there is just one result its the latest

Nov 11Feb 14Reference

WBC4.64.73.5-11

Haemoglogin15.915.613-17

Platlets171220150-400

RBC5.15.014.5-5.5

haematocrit0.4620.4470.4-0.5

MCV918980-100

MCH31.231.127-32

RDW12.812.911-15

neutrophils3.102.72-8

lymphocytes11.51-4

monocytes0.400.50.2-1

eosinphils0.0000-0.5

basophils0.0000-0.2

Sodium141141135-145

Potassium4.14.53.5-5.0

Chlorides10210095-108

Urea3.93.42.1-7.1

Creatine786862-106

Albumin454135-50

Bilrublin Total1181-21

Alk Phosphate (ALP)477035-129

Gamma GT44578-61

ALT20274-50

B12 781191-663

Vit D 49.4

Folate 14.73.5-16.0

Ferritin 26330-400

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  • Hi,

    Cant advise but interested to know what your test results mean, I must be reasing yours wrongs, mine are:-

    Bilirubin my result 5 normal range <21

    Alkaline P my result 33 Normal range 30-130

    ALT my result 11 normal range 5-40

    Albumin my result 42 normal range 35-50.

    I get pain in the liver area and red face but not really immediatly after drinking. All my results are "NORMAL" too???????

  • For example to read my results, my bilirublin, was 11 in 2011, now is 8, range is 1-21 and so on!!

    My LFTs seem higher than yours

    Im thinking for trying to get a CT or a fibroscan done if i can

    Still worried

    Thanks for your reply

  • Sorry still not sure I understand..they just all look like mixed up numbers to me!!!!! Never mind me!! I have had a 2 Fibroscans one in January just gone which was 6.3 and one last year was 6.7 so has come down a bit in that year.

    I think the ONLY conclusive test is a biopsy which they will not give you unless the scans or blood tets are out of range. Good luck and keep me updated.

  • My Lfts are in range as are your, I wonder if its better to have numbers near the middle of the range?

    For example my ALT is 27 right in middle yours lower.

    Did you have ultrasound first, if your LFTs normal was it your GP who put forward for Fibroscan?

    Is your result good or bad, can thet detect scarring if there?

    Im in dublin not sure what fibroscan there, i will organise MRI myself from next week, doctor says take it easy and come back 6 months!, but i dont think he understands liver as not specilaist and how much guinness i put away over the years!!

    Is biopsy always conclusive? Can it depend on the sample?

    Cheers

  • Hi Ollie...I am no expert believe me.. there are alot of other people on here that know what they are talking about I think. Bolly being one of them, not seen much from him...or her lately though.

    Have a look through my posts to see my details. I have been having symptoms for years now (about 3 maybe 4) But I am still drinking!

    No I had blood tests done 1st but pushed the docs for an Ultrasound both times and must admit they have been pretty good with me and sent me for it both times I have asked. I have had LOTS of tests normally every few months. I have also seen a hepatologist who have said I DONT have liver disease.

    I had the Fibroscan done through the British Liver Trust, they do a roadshow each January, go to different parts of the country and offer free fibroscans, shame you have just missed them. Anything under 7 is supposed to be considered as normal but I have read different opinions, again they assured me at the roadshow I was fine.

    Not sure about the biopsy though?

  • Definitely time to stop drinking: if you can do it for a month at a time, when not all the time?

    Re concerns: while you may get some insights from others' experiences, you really need to be having this conversation with your GP and/or consultant.

    Mike

  • All I would say is if you had cirrhosis or enlarged liver they should pick that up on the ultrasound, its not that inaccurate, they picked up my cirrhosis on it. If you want further tests then go for it if its going to put your mind at rest. You may of just got away with it, does happen sometimes but would advise you to stop drinking. No expert mind you but the test don't seem to indicate anything, just keep an eye on things, good luck.

  • Thanks nbee, i have decided to stop and call it a day, think i may also get an MRI for peace of mind. Will get more bloods done later this week, i will post updates here

  • Yeah if it comes back clear don't think you have anything to worry about. Im sure this experience has scared you a bit but learn from it. Don't go back to what you were doing, you might not be so lucky next time. Anyway all the best.

  • Regarding your liver please remember it does regenerate itself so stopping alcohol gives it a major boost in helping it regenerate. Exercise and a healthy diet help enormously too.....if the numbers are off recommended scales you should seek medical advise. You did not state your age and weight but one thing is for sure, cutting down alcohol. improving diet, and exercising are three big thumbs up for your liver!

  • Hi, i am 39 and my weight is nearly 15 stones, I am 6'2""

    Thanks!

  • Ollie, again you may pleasantly be surprised if you decide to spend the next 6 months with no alcohol, better diet and exercise....I did this and would recommend it to anyone based on the results...I am60yrs, 6'2" was 16 stone, now 14 stone and my ALT & AST halved back into the recommended range.

  • Hi Caramberman

    I intend i hope for more than 6 months!! Its good advice!

    i am going to update my posts here on my progress, and MRI scan and new bloods next week ( though probably too soon to show changes)

  • Still on my new healthy life

    Went to another doctor today and got bloods done, will post results when through.

    She examined were my dull pain is on right side- doctor was of view that it was localised and possibly muscular. She was also of the opinion that my red flushes were not liver related.

    Dont know what to think as she is a general doctor not liver specalist.

    I got a copy of the adominal ultrasound from other doctor, the one he told me was "ok"

    I post below, the person who was doing the ultrasound at the time told me that the liver looked "fine", and I got the impression that the bowel gas was more a problem with other organs.

    Anyway below the report. I should have the MRI scan in next days I hope, though hope it can go ahead with the titanium fasteners on my skull, i think i can.

    "Technically difficult examination due to extensive intra- abdominal bowel gas. Within this limitation the liver appeared of normal echotexture with no intra- hepatic bilary duct dilatation. Then says all other normal..."

    Im still a bit worried, i dont know if the ultasound any value, any thoughts?

  • I do not think you have gone too far at all. I am an alcoholic who has not used alcohol for over 4 years. I have had a liver transplant and do assure you that you will stand no chance of receiving one if you are drinking. Also, why take the chance of liver failure if you continue drinking. I also know that if I had just one drink then I would be taking the slippery path back down to the depths to which I had sunk. I wish you all the best.

  • hi and welcome-your experience is pretty similar to mine-I would say though that you've probably caught it in time-my first signs of liver stress were red flushes in the face. Your bloods look pretty normal-GGT 61 ? correct-doesn't look too bad for a heavy drinker. As others have said-if you can stick to light or moderate drinking then do so.If not then give it up! 50 pint per week binges will inevitably lead to fatty liver at the very least in time. Even if you have borderline fatty liver now-it can be reversed with periods of abstinence. Good luck

  • Hi,

    Thanks for your reply. How long did you have red flushes in face for? And did they lead to anything?

    ggt was 57 last time, 8-61 was range i have new bloods coming which i will post

    50 pints a week only happened 4/5 times over the period, wanted to show the max

    Have not had a beer for over three weeks now, and intend not to for at least another 3, and maybe knock on head for good, or have a limit of 6 pints per month.

  • The red flushes started a couple of years back-I'd been drinking the best part of a bottle of wine a day for years-with occasional breaks. Too be honest-it soon disappeared when I knocked the drinking on the head or returned to moderate drinking. A prolonged period of bingeing will cause it. Your blood results look fine-I'm surprised you're being referred for further investigation-useful to have a baseline though. Stick to the recommended units and have 2-3 days off a week and you'll be fine. The occasional blowout won't hurt you if you do that. I'm late fifties now and have normal bloods except high ggts( 200ish) and a fibroscan of 7.6 so some damage has probably been done(fatty liver) but I'm now only drinking on high days and holidays! keep us posted!

  • I get these as well Briccolone.along with everthing else... Saw a dermatologist the other week about the itch, he couldnt diagnose a problem, done a chest xray of which nothing has come back so that must be all clear.. Latest symptoms are painful feet, like a feeling of swelling and sometimes wrists and hands too.. Have been checked for pretty much everything possible I think. I did have a weak positive ANA Hep 2 result on the last lot of tests but doc says thats noting on its own and my kidney function has been going down apparently for the past year.. dont know what that means...

    I am assuming Ollie is going private.. Why do all doctors say liver pain is muscular or IBS.. the liver doesnt feel pain!!!!!

  • Hi sunflower-the fact that your fibroscan results improved after moderating your lifestyle says to me that your liver was slightly stressed and has improved. You've had a lot of tests and nothing conclusive which I know is a concern but like we've discussed you can have symptoms and bloods look fine. The only time I became asymtomatic was after 3 months abstinence. What happens if you don't drink for let's say a month? Do all symptoms go?

  • I think it's clear though sunflower that you don't have cirrhosis or anything like it- you may be drawing the wrong conclusions by self diagnosis-I know- we all do it! Swollen extremities can be caused by many things - have you tried diuretics? A low functioning kidney sounds more likely too me but the docs should've making these calls. All the best

  • As Always Briccolone thanks for listening.. you know I am obsessed with it!!! No symptoms dont go after a month off, pins and needles seem to be back a bit more but I am still drinking, itching comes and goes too.

    I remember talking to a doctor before who said it can change "just like that" but other people say it takes years to change, there are SOOO many different variations it seems why is it not clear cut!!!

    Sorry what are dirueitcs? Are kidney and liver problems related do you know? Thanks as usual!

  • Your swollen hands/feet and low functioning kidneys fit together. The kidneys work to remove fluid from the body, so if your kidneys are not functioning tip top then your body will retain fluid, hence your hands and feet swelling. I think a kidney problem is much more likely to be causing some of your symptoms than a liver one.

    Diuretics are drugs that get excess fluids out of your body by increasing the amount of urine you pass.

  • Thanks for your response Bolly, Not heard from you in a while hope you are well. Tests back yesterday but receptionist said "normal". I did just have the "feeling" of swelling in my feet when I originaly posted this but last week my ankle did actually swell I have sometimes really terrrible pain in my feet as well. Really dont know where to go with all of this now :-(

  • " Really dont know where to go with all of this now :-( "... well its up to you whether you action the suggestions given by lots of people on here, particularly those who recommend you lay off the alcohol (as you are concerned about liver damage and your flushes/itching seem to be linked to it), but if, as you say above, you are still drinking, then it seems some advice has been difficult for you to put in to practice.

  • Hi

    Good Afternoon all

    I am still off alcohol and trying to eat well.

    I post my last blood results as of 19 Feb 2014, any comments much appreciated! I had a bit of a sore throat the day of the test.

    I have been taking Milk Thistle, Dandelion, Artichoke; lots of fish, no red meat and lots of water. Also lots of fruit juices

    I am waiting for my MRI appointment, will keep updated. I also post below the full Summary text of my Ultrasound, this is all the information I have. I am pushing for the MRI for peace of mind.

    On the note below, they do not mention size of liver, is it too much to assume its ok, or they could not measure it?

    “Technically difficult examination due to extensive intra-abdominal bowel gas. Within this limitation to liver appeared of normal echotexture with no intra-hepatic bilary duct dilatation.

    Gallbladder, spleen, both kidneys, aorta and IVC normal. The pancreas could not be assessed due to overlying bowel gas. Urinary bladder and prostate appeared normal. No Pelvic mass of free fluid.”

    Albumin 49 (35-50)

    Bilrublin Total 10 (1-21)

    Alk Phosphate (ALP) 72 (40-129)

    GTT 42 (10-71)

    ALT 23 (0-41)

    AST 18 (0-40)

    Serum Iron 25 (11-34)

    TIBC/C:TIBC (Calculated) 55 (50-85)

    TSAT% Transferrin Satn 45% (<45%) was 27% month before

    Folate 18.8 (4.5-20)

    Ferritin 225 (23-393)

    Total Protein 75 (66-87)

    White Blood Cells 3.3 (3.5-11) was 4.7 Previous month

    Haemoglogin 15.7 (13-17)

    Platlets 181 (150-400) was 220 Previous month)

    RBC 5.16 (4.5-5.5)

    Haematocrit 0.465 (0.4-0.5)

    MCV 90.1 (80-100)

    MCH 30.4 (27-32)

    RDW 13.2 (11-15)

    PT 10.5 Seconds (9.9-12.5)

    APTT 32.2 Seconds (24-35)

    Sodium 144 (135-145)

    Potassium 4.6 (3.5-5.0)

    Urea 2.7 (2.5-7.8)

    Creatine 64 (62-106)

    Urea and Creatine have dropped values over last year

  • Good luck with everything especially the MRI scan - it's good to have peace of mind. I don't have any idea of the readings due to me being new to the site. Will look forward to hearing your results though and hopefully everything will be fine. Take good care. :)

  • Hi Ollie;

    I can't really offer any advice but i seem to be in the same position as yourself!

    I have the same drinking pattern and while I Have no symptoms I had a clear ultrasound scan in june last year because I had pain in my abdomen. The doc described my scan as 'pristine' and said 'you don't drink much alcohol'....i near fainted at that!!! How ever my GGT has been high since 2010 150-315. Alsoand my aklp is high but i do have bone disease and that is and Aklp is an indicater. Like yourself would like some info!

  • hi-don't know how long you've been drinking but if its more than ten years then I suggest you change your drinking habits before you do get some symptoms-a couple of days of week and less than 21 units if you're a male then you should be fine. Doctors don't seem to get excited at GGt levels like yours-although it's an indicator of fatty liver and high alcohol use-a clear ultrasound is saying not however.

  • Thanks to all for replies

    Hi all

    Still no beer :)

    After a lot of pushing i managed to get the MRI with contrast. My new doctor was not of view i needed, but i pushed with reasons (1) my red flushes (2) pain in side (3) relatively high ferritin (4) ultrasound ok but not fully conclusive (5) LFT not exact science (6) i would look at legal action

    And this was to get a private appointment!!

    I had this on wednesday. It lasted 30 mins or so. No results as yet but i bumped into radiologist after and asked him how was my liver, he just said seemed ok. Could he know that quick?

    I will get results on tuesday at doctor. Bit nervous waiting!!, will update then

  • Was at doctors this morning and below is MRI report. Doctor said he rang radiologist and the radiologist said was not of concern, but are cysts normal?

    any advice appreciated!!!

    MRI Liver with Contrast

    "Standard protocol

    The liver appeared normal apart from a 7mm cyst within the dome of the left lobe. Normal calibre intra-hepatic ducts and CBD

    The pancreas, spleen and both adrenals along with the visualised portions of kidneys appeared normal. No enlarged lymph nodes or other abnormality identified through the upper abdomen"

  • There is some easy to read information about liver cysts here, on the British Liver Trust website:

    britishlivertrust.org.uk/li...

  • I have been doing some research and it seems small liver cysts can be common.

    Though I would prefer not to have any, and at least gives me the reason to be recommended for annual MRI to monitor as you

    How good is an MRI with contrast to rule out cirrosiss?, with my labs, ok US and MRI, its high probability I should be ok, I hope

    I have been looking at my labs over the last 2 years, one pattern I notice is my levels of creatine and urea. Over 6 labs tests over last two years they have dropped each time, they are both now close to lower reference band, cause for concern?

    Creatine

    2012 Value 78

    2014. Value 64

    Ref range. (62-106)

    Urea

    2012. Value 3.9

    2014. Value 2.7

    Ref range (2.5 - 7.8)

    I know low levels in these two can indicate liver damage, but with my other "good" results , I can sort of ignore this? Could this be normal change?

  • Hi all

    Hope everyone is ok, i am doing ok, i had a couple of relasp incidents recently, both were mates stag parties, but however no excuse

    I was doing so so good, now back healthy and will try very hard not to stumble again

    but generally I have been doing ok, donated blood as well recently for first time.

    Over the last month following stags, I have been experiencing sore bones which came on quite quickly, fingers and toes of note, my wrist has been quite sore for about 4 weeks, bloods done 3 weeks ago seemed ok, white bloods up from 4.5 to 6.5 was only real change of note

    My mum has bad arthritis, not sure if it can pass on

    I have been having some pain below right rib cage, it has woken me up, i am also doing lots of bowel movements, stool seems ok, and i notice my ankles are swollen yesterday ( seems like fluid, no stomach swelling) anyone have any thoughts in possible connections of above in relation to cirrhosis etc?

    I had an ok MRi and US in march, is it possible to go downhill so fast I wonder

  • Hey Ollie, no advice but nice to see a familiar name back on the board... if you know what I mean!! I have had pain lower left ribs for about 3 years now, alll docs say is IBS, had pain on the left side recently as well, spleen?? Also ankle was swollen earlier in the year and now and again they feel like they should be swollen but not.

    Still get itching, pins and needles achy joints etc, etc,etc,etc.. I do still drink, generally at weekends and then a few weeks off at a time. Keep us up to date.

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